(a) Scope and Application. This section applies to all occupational exposure
to blood or other potentially infectious materials as defined by subsection (b) of this
section.

EXCEPTION: This regulation does not apply to the construction industry.

(b) Definitions. For purposes of this section, the following shall apply:

"Biological Cabinet" means a device enclosed except for necessary exhaust
purposes on three sides and top and bottom, designed to draw air inward by means of
mechanical ventilation, operated with insertion of only the hands and arms of the user,
and in which virulent pathogens are used. Biological cabinets are classified as:

(1) Class I: A ventilated cabinet for personnel protection with an unrecirculated
inward airflow away from the operator and high-efficiency particulate air (HEPA) filtered
exhaust air for environmental protection.

(2) Class II: A ventilated cabinet for personnel, product, and environmental protection
having an open front with inward airflow for personnel protection, HEPA filtered laminar
airflow for product protection, and HEPA filtered exhaust air for environmental
protection.

(3) Class III: A total enclosed, ventilated cabinet of gas-tight construction.
Operations in the cabinet are conducted through attached protective gloves.

"Decontamination" means the use of physical or chemical means to remove,
inactivate, or destroy bloodborne pathogens on a surface or item to the point where they
are no longer capable of transmitting infectious particles and the surface or item is
rendered safe for handling, use, or disposal. Decontamination includes procedures
regulated by Health and Safety Code Section 25090118275.

(1) A physical attribute built into a needle device used for withdrawing body
fluids, accessing a vein or artery, or administering medications or other fluids, which
effectively reduces the risk of an exposure incident by a mechanism such as barrier
creation, blunting, encapsulation, withdrawal or other effective mechanisms; or

(2) A physical attribute built into any other type of needle device, or into a
non-needle sharp, which effectively reduces the risk of an exposure incident.

"Exposure Incident" means a specific eye, mouth, other mucous membrane,
non-intact skin, or parenteral contact with blood or other potentially infectious
materials that results from the performance of an employee's duties.

"Handwashing Facilities" means a facility providing an adequate supply of
running potable water, soap and single use towels or hot air drying machines.

"HBV" means hepatitis B virus.

"HCV" means hepatitis C virus.

"HIV" means human immunodeficiency virus.

"Licensed Healthcare Professional" is a person whose legally
permittedlicensed scope of practice allowsincludeshim or her to independently perform thean activitiesyrequired by subsection (f), Hepatitis B Vaccination and Post-exposure Evaluation
and Follow-upwhich this section requires to be performed by a licensed
healthcare professional.

"Needle" or "Needle Device" means a needle of any type, including,
but not limited to, solid and hollow-bore needles.

"Needleless system" means a device that does not utilize needles for:

(1) The withdrawal of body fluids after initial venous or arterial access is
established;

(2) The administration of medication or fluids; and

(3) Any other procedure involving the potential for an exposure incident.

"NIOSH" means the Director of the National Institute for Occupational Safety
and Health, U.S. Department of Health and Human Services, or designated representative.

"Occupational Exposure" means reasonably anticipated skin, eye, mucous
membrane, or parenteral contact with blood or other potentially infectious materials that
may result from the performance of an employee's duties.

"One-Hand Technique" means a procedure wherein the needle of a
reusable syringe is capped in a sterile manner during use. The technique employed shall
require the use of only the hand holding the syringe so that the free hand is not exposed
to the uncapped needle.

"OPIM" means other potentially infectious materials.

"Other Potentially Infectious Materials" means:

(1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid,
synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva
in dental procedures, any other body fluid that is visibly contaminated with blood such as
saliva or vomitus, and all body fluids in situations where it is difficult or impossible
to differentiate between body fluids such as emergency response;

(2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead);
and

(3) Any of the following, if known or reasonably likely to contain or be infected
with HIV, HBV, or HCV:

HIV-containing cell or tissue cultures, organ cultures, and HIV-or
HBV-containing culture medium or other solutions; and blood, organs, or other tissues from
experimental animals infected with HIV or HBV.

"Parenteral" means piercing mucous membranes or the skin barrier through such
events as needlesticks, human bites, cuts, and abrasions.

"Personal Protective Equipment" is specialized clothing or equipment worn or
used by an employee for protection against a hazard. General work clothes (e.g., uniforms,
pants, shirts or blouses) not intended to function as protection against a hazard are not
considered to be personal protective equipment.

"Production Facility" means a facility engaged in industrial-scale,
large-volume or high concentration production of HIV,or HBV or
HCV.

"Regulated Waste" means liquid or semi-liquid blood or other potentially
infectious materials; contaminated items that would release blood or other potentially
infectious materials in a liquid or semi-liquid state if compressed; items that are caked
with dried blood or other potentially infectious materials and are capable of releasing
these materials during handling; contaminated sharps; and pathological and microbiological
wastes containing blood or other potentially infectious materials. Regulated Waste
includes "medical waste" regulated by Health and Safety Code Chapter 6.1.

"Regulated Waste" means any of the following:

(1) Liquid or semi-liquid blood or OPIM;

(2) Contaminated items that:

(A)Contain liquid or semi-liquid blood, or are caked with dried blood or
OPIM; and

(B)Are capable of releasing these materials when handled or compressed.

"Research Laboratory" means a laboratory producing or using
research-laboratory-scale amounts of HIV,or HBV or HCV.
Research laboratories may produce high concentrations of HIV,or
HBV or HCV but not in the volume found in production facilities.

"Sharp" means any object used or encountered in the industries covered by
subsection (a) that can be reasonably anticipated to penetrate the skin or any other part
of the body, and to result in an exposure incident, including, but not limited to, needle
devices, scalpels, lancets, broken glass, broken capillary tubes, exposed ends of dental
wires and dental knives, drills and burs.

"Sharps Injury" means any injury caused by a sharp, including, but not
limited to, cuts, abrasions, or needlesticks.

"Sharps Injury Log" means a written or electronic record satisfying the
requirements of subsection (c)(2).

"Source Individual" means any individual, living or dead, whose blood or other
potentially infectious materialsOPIM may be a source of occupational
exposure to the employee. Examples include, but are not limited to, hospital and clinic
patients; clients in institutions for the developmentally disabled; trauma victims;
clients of drug and alcohol treatment facilities; residents of hospices and nursing homes;
human remains; and individuals who donate or sell blood or blood components.

"Sterilize" means the use of a physical or chemical procedure to destroy all
microbial life including highly resistant bacterial endospores. Sterilization includes
procedures regulated by Health and Safety Code Section 25090.

"Universal Precautions" is an approach to infection control. According to the
concept of Universal Precautions, all human blood and certain human body fluids are
treated as if known to be infectious for HIV, HBV, HCV, and other bloodborne
pathogens.

"Work Practice Controls" means controls that reduce the likelihood of
exposure by alteringdefining the manner in which a task is
performed (e.g., prohibiting recapping of needles by a two-handed technique and use of
patient-handling techniques).

(c) Exposure Response, Prevention and Control.

(1) Exposure Control Plan.

(A) Each employer having an employee(s) with occupational exposure as defined by
subsection (b) of this section shall establish, implement and maintain an effectivea written Exposure Control Plan, which is designed to eliminate or
minimize employee exposure and which is also consistent with Section 3203.

(B) The Exposure Control Plan shall be in writing and shall contain at
least the following elements:

1. The exposure determination required by subsection (c)(2)3);

2. The schedule and method of implementation for each of the applicable
subsections: (d) Methods of Compliance, (e) HIV,and HBV and
HCV Research Laboratories and Production Facilities, (f) Hepatitis B Vaccination and
Post-exposure Evaluation and Follow-up, (g) Communication of Hazards to Employees, and (h)
Recordkeeping, of this standard; and

3. The procedure for the evaluation of circumstances surrounding exposure
incidents as required by subsection (f)(3)(A).

By July 1, 1999, the Exposure Control Plan shall additionally contain the following
elements required by subsections (c)(1)(B) 4. through 8.:

4.An effective procedure for gathering the information required by the
Sharps Injury Log.

5.An effective procedure for periodic determination of the frequency of
use of the types and brands of sharps involved in the exposure incidents documented on the
Sharps Injury Log;

NOTE: Frequency of use may be approximated by any reasonable and effective
method.

6.An effective procedure for identifying currently available engineering
controls, and selecting such controls, where appropriate, for the procedures performed by
employees in their respective work areas or departments;

8.An effective procedure for obtaining the active involvement of
employees in reviewing and updating the exposure control plan with respect to the
procedures performed by employees in their respective work areas or departments.

(C) Each employer shall ensure that a copy of the Exposure Control Plan is
accessible to employees in accordance with Section 3204(e).

(D) The Exposure Control Plan shall be reviewed and updated at least annually and
whenever necessary as follows:

1.tTo reflect new or modified tasks and procedures
which affect occupational exposure,;

2.By July 1, 1999, if sharps are used in the employer's place of
employment, to reflect progress in implementing the use of needleless systems and sharps
with engineered sharps injury protection.

3.tTo reflectinclude new
or revised employee positions with occupational exposure;and

4.tTo review and evaluate the exposure
incidents which occurred since the previous update; and

5.To review and respond to information indicating that the Exposure
Control Plan is deficient in any area.

(E) The Exposure Control Plan shall be made available to the Chief or NIOSH or
their respective designee upon request for examination and copying.

(2) Sharps Injury Log.

The employer shall establish and maintain a Sharps Injury Log, which is a record of
each exposure incident involving a sharp. The exposure incident shall be recorded on the
log within 14 working days of the date the incident is reported to the employer. The
information recorded shall include the following information, if known or reasonably
available:

(A) Date and time of the exposure incident;

(B) Type and brand of sharp involved in the exposure incident;

(C) By July 1, 1999, a description of the exposure incident which shall include:

1. Job classification of the exposed employee;

2. Department or work area where the exposure incident occurred;

3. The procedure that the exposed employee was performing at the time of the incident;

4. How the incident occurred;

5.. The body part involved in the exposure incident;

6. If the sharp had engineered sharps injury protection, whether the protective
mechanism was activated, and whether the injury occurred before the protective mechanism
was activated, during activation of the mechanism or after activation of the mechanism, if
applicable;

7. If the sharp had no engineered sharps injury protection, the injured employee's
opinion as to whether and how such a mechanism could have prevented the injury; and

8. The employee's opinion about whether any other engineering, administrative or work
practice control could have prevented the injury.

(3) Exposure Determination.

(A) Each employer who has an employee(s) with occupational exposure as defined by
subsection (b) of this section shall prepare an exposure determination. This exposure
determination shall contain the following:

1. A list of all job classifications in which all employees in those job
classifications have occupational exposure;

2. A list of job classifications in which some employees have occupational exposure;
and

3. A list of all tasks and procedures or groups of closely related task and procedures
in which occupational exposure occurs and that are performed by employees in job
classifications listed in accordance with the provisions of subsection (c)(23)(A)2.
of this standard.

(B) This exposure determination shall be made without regard to the use of personal
protective equipment.

(d) Methods of Compliance.

(1) General. Universal precautions shall be observed to prevent contact with blood or other
potentially infectious materialsOPIM. Under circumstances in which
differentiation between body fluid types is difficult or impossible, all body fluids shall
be considered potentially infectious materials.

(2) Engineering and Work Practice Controls--General Requirements.

(A) Engineering and work practice controls shall be used to eliminate or minimize
employee exposure. Where occupational exposure remains after institution of these
controls, personal protective equipment shall also be used.

(B) Engineering controls shall be examined and maintained or replaced on a
regular schedule to ensure their effectiveness.

(C) Employers shall provide handwashing facilities which are readily accessible
to employees.Work practice controls shall be evaluated and updated on a
regular schedule to ensure their effectiveness.

(D) When provision of handwashing facilities is not feasible, the employer
shall provide either an appropriate antiseptic hand cleanser in conjunction with clean
cloth/paper towels or antiseptic towelettes. When antiseptic hand cleansers or towelettes
are used, hands shall be washed with soap and running water as soon as feasible.All
procedures involving blood or OPIM shall be performed in such a manner as to minimize
splashing, spraying, spattering, and generation of droplets of these substances.

(E) Employers shall ensure that employees wash their hands immediately or
as soon as feasible after removal of gloves or other personal protective equipment.

(F) Employers shall ensure that employees wash hands and any other
skin with soap and water, or flush mucous membranes with water immediately or as soon as
feasible following contact of such body areas with blood or other potentially infectious
materials.

(G) Contaminated needles and other contaminated sharps shall not be
bent, recapped, or removed except as noted in subsections (d)(2)(G)1. and (d)(2)(G)2.
below. Shearing or breaking of contaminated needles is prohibited.

1. Contaminated needles and other contaminated sharps shall not be bent,
recapped or removed unless the employer can demonstrate that no alternative is feasible or
that such action is required by a specific medical or dental procedure.

2. Such bending, recapping or needle removal must be accomplished through the use of a
mechanical device or a one-handed technique.

4. In accordance with the requirements set forth in subsection (d)(4)(B)5. for reusable
sharps.

(I) Eating, drinking, smoking, applying cosmetics or lip balm, and handling
contact lenses are prohibited in work areas where there is a reasonable likelihood of
occupational exposure.

(J) Food and drink shall not be kept in refrigerators, freezers,
shelves, cabinets or on countertops or benchtops where blood or other potentially
infectious materials are present.

(K) All procedures involving blood or other potentially infectious
materials shall be performed in such a manner as to minimize splashing, spraying,
spattering, and generation of droplets of these substances.

(L) Mouth pipetting/suctioning of blood or other potentially
infectious materials is prohibited.

(M) Specimens of blood or other potentially infectious materials shall
be placed in a container which prevents leakage during collection, handling, processing,
storage, transport, or shipping.

1. The container for storage, transport, or shipping shall be labeled or
color-coded according to subsection (g)(1)(A), and closed prior to being stored,
transported, or shipped. When a facility utilizes Universal Precautions in the handling of
all specimens, the labeling/color-coding of specimens is not necessary provided containers
are recognizable as containing specimens. This exemption only applies while such
specimens/containers remain within the facility. Labeling or color-coding in accordance
with subsection (g)(1)(A) is required when such specimens/containers leave the facility.

2. If outside contamination of the primary container occurs, the primary container
shall be placed within a second container which prevents leakage during collection,
handling, processing, storage, transport, or shipping and is labeled or color-coded
according to the requirements of this standard.

3. If the specimen could puncture the primary container, the primary container shall be
placed within a secondary container which is puncture-resistant in addition to the above
characteristics.

(N) Equipment which may become contaminated with blood or other potentially
infectious materials shall be examined prior to servicing or shipping and shall be
decontaminated as necessary, unless the employer can demonstrate that decontamination of
such equipment or portions of such equipment is not feasible.

1. A readily observable label in accordance with subsection (g)(1)(A)8. shall
be attached to the equipment stating which portions remain contaminated.

2. The employer shall ensure that this information is conveyed to all affected
employees, the servicing representative, and/or the manufacturer, as appropriate, prior to
handling, servicing, or shipping so that appropriate precautions will be taken.

(3) Engineering and Work Practice Controls--Specific Requirements.

(A)Needleless Systems, Needle Devices and Non-Needle Sharps. By July 1,
1999, the employer shall comply with the following requirements:

1.Needleless Systems. Needleless systems shall be used for:

a. Withdrawal of body fluids after initial venous or arterial access is established;

b. Administration of medications or fluids; and

c. Any other procedure involving the potential for an exposure incident for which a
needleless system is available as an alternative to the use of needle devices.

2.Needle Devices. If needleless systems are not used, needles with
engineered sharps injury protection shall be used for:

a. Withdrawal of body fluids;

b. Accessing a vein or artery;

c. Administration of medications or fluids; and

d. Any other procedure involving the potential for an exposure incident for which a
needle device with engineered sharps injury protection is available.

3.Non-Needle Sharps. If sharps other than needle devices are used, these
items shall include engineered sharps injury protection.

EXCEPTIONS: The following exceptions apply to the engineering controls required by
subsection (d)(3)(A):

1.Market Availability. The engineering control is not required if it is
not available in the marketplace.

2.Patient Safety. The engineering control is not required if a licensed
healthcare professional directly involved in a patient's care determines, in the
reasonable exercise of clinical judgement, that use of the engineering control will
jeopardize the patient's safety or the success of a medical, dental or nursing procedure
involving the patient. The determination shall be documented according to the procedure
required by (c)(1)(B)6.

3.Safety Performance. The engineering control is not required if the
employer can demonstrate by means of objective product evaluation criteria that the
engineering control is not more effective in preventing exposure incidents than the
alternative used by the employer.

4.Availability of Safety Performance Information. The engineering
control is not required if the employer can demonstrate that reasonably specific and
reliable information is not available on the safety performance of the engineering control
for the employer's procedures, and that the employer is actively determining by means of
objective product evaluation criteria whether use of the engineering control will reduce
the risk of exposure incidents occurring in the employer's workplace.

(B)Prohibited Practices.

1.Shearing or breaking of contaminated needles and other contaminated sharps
is prohibited.

2.Contaminated sharps shall not be bent, recapped, or removed from
devices.

EXCEPTION: Contaminated sharps may be bent, recapped or removed from devices if the
procedure is performed using a mechanical device or a one-handed technique, and the
employer can demonstrate that no alternative is feasible or that such action is required
by a specific medical or dental procedure.

3.Sharps that are contaminated with blood or OPIM shall not be stored or
processed in a manner that requires employees to reach by hand into the containers where
these sharps have been placed.

4.Disposable sharps shall not be reused.

5.Broken Glassware. Broken glassware which may be contaminated shall not
be picked up directly with the hands. It shall be cleaned up using mechanical means, such
as a brush and dust pan, tongs, or forceps.

7.Sharps containers shall not be opened, emptied, or cleaned manually or
in any other manner which would expose employees to the risk of sharps injury.

8.Mouth pipetting/suctioning of blood or OPIM is prohibited.

9.Eating, drinking, smoking, applying cosmetics or lip balm, and
handling contact lenses are prohibited in work areas where there is a reasonable
likelihood of occupational exposure.

10.Food and drink shall not be kept in refrigerators, freezers, shelves,
cabinets or on countertops or benchtops where blood or OPIM are present.

(C)Requirements for Handling Contaminated Sharps.

1.All procedures involving the use of sharps in connection with patient
care, such as withdrawing body fluids, accessing a vein or artery, or administering
vaccines, medications or fluids, shall be performed using effective patient-handling
techniques and other methods designed to minimize the risk of a sharps injury.

2.Immediately or as soon as possible after use, contaminated sharps
shall be placed in containers meeting the requirements of subsection (d)(3)(D) as
applicable.

3.At all time during the use of sharps, containers for contaminated sharps
shall be:

a. Easily accessible to personnel and located as close as is feasible to the
immediate area where sharps are used or can be reasonably anticipated to be found (e.g.,
laundries);

b. Maintained upright throughout use, where feasible; and

c. Replaced as necessary to avoid overfilling.

(D)Sharps Containers for Contaminated Sharps.

1. All sharps containers for contaminated sharps shall be:

a. Rigid;

b.Puncture resistant;

c.Leakproof on the sides and bottom;

d.Portable, if portability is necessary to ensure easy access by the
user as required by subsection (d)(3)(C)3.a.; and

e.Labeled in accordance with subsection (g)(1)(A)(2).

2.If discarded sharps are not to be reused, the sharps container shall also
be closeable and sealable so that when sealed, the container is leak resistant and
incapable of being reopened without great difficulty.

(E)Regulated Waste.

1. General.

Handling, storage, treatment and disposal of all regulated waste shall be in accordance
with Health and Safety Code Chapter 6.1, Sections 117600 through 118360, and other
applicable regulations of the United States, the State, and political subdivisions of the
State.

2. Disposal of Sharps Containers.

When any container of contaminated sharps is moved from the area of use for the
purpose of disposal, the container shall be:

a. Closed immediately prior to removal or replacement to prevent spillage or protrusion
of contents during handling, storage, transport, or shipping; and

b. Placed in a secondary container if leakage is possible. The second container shall
be:

i.Closable;

ii.Constructed to contain all contents and prevent leakage during handling,
storage, transport, or shipping; and

iii.Labeled according to subsection (g)(1)(A) of this section.

3.Disposal of Other Regulated Waste. Regulated waste not consisting of
sharps shall be disposed of in containers which are:

a. Closable;

b. Constructed to contain all contents;

c. Labeled and color-coded in accordance with subsection (g)(1)(A) of this section; and

d. Closed prior to removal to prevent spillage or protrusion of contents during
handling, storage, transport, or shipping.

4.If outside contamination of a container of regulated waste occurs, it
shall be placed in a second container. The second container shall be:

a. Closable;

b. Constructed to contain all contents and prevent leakage of fluids during handling,
storage, transport or shipping;

c. Labeled and color-coded in accordance with subsection (g)(1)(A) of this section; and

d. Closed prior to removal to prevent spillage or protrusion of contents during
handling, storage, transport, or shipping.

(F)Handling Specimens of Blood or OPIM.

Specimens of blood or OPIM shall be placed in a container which prevents leakage
during collection, handling, processing, storage, transport, or shipping.

1. The container for storage, transport, or shipping shall be labeled or color-coded
according to subsection (g)(1)(A), and closed prior to being stored, transported, or
shipped. When a facility utilizes Universal Precautions in the handling of all specimens,
the labeling/color-coding of specimens is not necessary provided containers are
recognizable as containing specimens. This exemption only applies while such
specimens/containers remain within the facility. Labeling or color-coding in accordance
with subsection (g)(1)(A) is required when such specimens/containers leave the facility.

2. If outside contamination of the primary container occurs, the primary container
shall be placed within a second container which prevents leakage during collection,
handling, processing, storage, transport, or shipping and is labeled or color-coded
according to the requirements of this standard.

3. If the specimen could puncture the primary container, the primary container shall
be placed within a secondary container which is puncture-resistant in addition to the
above characteristics.

(G)Servicing or Shipping Contaminated Equipment.

Equipment which may become contaminated with blood or OPIM shall be examined prior
to servicing or shipping and shall be decontaminated as necessary, unless the employer can
demonstrate that decontamination of such equipment or portions of such equipment is not
feasible.

1. A readily observable label in accordance with subsection (g)(1)(A)8. shall be
attached to the equipment stating which portions remain contaminated.

2. Information concerning all remaining contamination shall be conveyed to all affected
employees, the servicing representative, and/or the manufacturer, as appropriate, prior to
handling, servicing, or shipping so that appropriate precautions will be taken.

(H)Cleaning and Decontamination of the Worksite.

1. General Requirements.

a. Employers shall ensure that the worksite is maintained in a clean and sanitary
condition.

b. Employers shall determine and implement an appropriate written schedule for cleaning
and decontamination of the worksite.

c. The method of cleaning or decontamination used shall be effective and shall be
appropriate for the:

i. Location within the facility;

ii. Type of surface or equipment to be treated;

iii. Type of soil or contamination present; and

iv. Tasks or procedures being performed in the area.

d. All equipment and environmental and work surfaces shall be cleaned and
decontaminated after contact with blood or OPIM no later than at the end of the shift.
Cleaning and decontamination of equipment and work surfaces is required more often as
specified below.

2. Specific Requirements.

a. Contaminated Work Surfaces. Contaminated work surfaces shall be cleaned and
decontaminated immediately or as soon as feasible when:

i. Surfaces become overtly contaminated;

ii. There is a spill of blood or OPIM;

iii. Procedures are completed; and

iv. At the end of the work shift if the surface may have become contaminated since the
last cleaning.

b. Receptacles. All bins, pails, cans, and similar receptacles intended for reuse
which have a reasonable likelihood for becoming contaminated with blood or OPIM shall be
inspected and decontaminated on a regularly scheduled basis and cleaned and decontaminated
immediately or as soon as feasible upon visible contamination.

c. Protective Coverings. Protective coverings, such as plastic wrap, aluminum foil, or
imperviously-backed absorbent paper used to cover equipment and environmental surfaces,
shall be removed and replaced as soon as feasible when they become overtly contaminated or
at the end of the workshift if they may have become contaminated during the shift.

2. When provision of handwashing facilities is not feasible, the employer shall provide
either an appropriate antiseptic hand cleanser in conjunction with clean cloth/paper
towels or antiseptic towelettes. When antiseptic hand cleansers or towelettes are used,
hands shall be washed with soap and running water as soon as feasible.

3. Employers shall ensure that employees wash their hands immediately or as soon as
feasible after removal of gloves or other personal protective equipment.

4. Employers shall ensure that employees wash hands and any other skin with soap and
water, or flush mucous membranes with water immediately or as soon as feasible following
contact of such body areas with blood or OPIM.

(J) Laundry.

1. Contaminated laundry shall be handled as little as possible with a minimum of
agitation.

a. Contaminated laundry shall be bagged or containerized at the location where it
was used and shall not be sorted or rinsed in the location of use.

b. Contaminated laundry shall be placed and transported in bags or containers labeled
or color-coded in accordance with subsection (g)(1)(A) of this standard. When a facility
utilizes Universal Precautions in the handling of all soiled laundry, alternative labeling
or color-coding is sufficient if it permits all employees to recognize the containers as
requiring compliance with Universal Precautions.

c. Whenever contaminated laundry is wet and presents a reasonable likelihood of soaking
through or leakage from the bag or container, the laundry shall be placed and transported
in bags or containers which prevent soak-through and/or leakage of fluids to the exterior.

2. The employer shall ensure that employees who have contact with contaminated
laundry wear protective gloves and other appropriate personal protective equipment.

3. When a facility ships contaminated laundry off-site to a second facility which does
not utilize Universal Precautions in the handling of all laundry, the facility generating
the contaminated laundry must place such laundry in bags or containers which are labeled
or color-coded in accordance with subsection (g)(1)(A).

(34) Personal Protective Equipment.

(A) Provision. When there is occupational exposureWhere
occupational exposure remains after institution of engineering and work practice controls,
the employer shall provide, at no cost to the employee, appropriate personal protective
equipment such as, but not limited to, gloves, gowns, laboratory coats, face shields or
masks and eye protection, and mouthpieces, resuscitation bags, pocket masks, or other
ventilation devices. Personal protective equipment will be considered
"appropriate" only if it does not permit blood or other potentially
infectious materialsOPIM to pass through to or reach the employee's work
clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under
normal conditions of use and for the duration of time which the protective equipment will
be used.

NOTE: For fire fighters, these requirements are in addition to those specified in
Sections 3401 through 3411, and are intended to be consistent with those requirements.

(B) Use. The employer shall ensure that the employee uses appropriate personal
protective equipment unless the employer shows that the employee temporarily and briefly
declined to use personal protective equipment when, under rare and extraordinary
circumstances, it was the employee's professional judgment that in the specific instance
its use would have prevented the delivery of health care or public safety services or
would have posed an increased hazard to the safety of the worker or co-worker. When the
employee makes this judgement, the circumstances shall be investigated and documented in
order to determine whether changes can be instituted to prevent such occurrences in the
future. The employer shall encourage employees to report all such instances without fear
of reprisal in accordance with Section 3203.

(C) Accessibility. The employer shall ensure that appropriate personal protective
equipment in the appropriate sizes is readily accessible at the worksite or is issued to
employees. Hypoallergenic gloves, glove liners, powderless gloves, or other similar
alternatives shall be readily accessible to those employees who are allergic to the gloves
normally provided.

(D) Cleaning, Laundering, and Disposal. The employer shall clean, launder, and dispose
of personal protective equipment required by subsections (d) and (e) of this standard, at
no cost to the employee.

(E) Repair and Replacement. The employer shall repair or replace personal protective
equipment as needed to maintain its effectiveness, at no cost to the employee.

(F) Removal.

1. If a garment(s) is penetrated by blood or other potentially
infectious materialsOPIM, the garment(s) shall be removed immediately or
as soon as feasible.

(G)2. All personal protective equipment shall be removed prior
to leaving the work area.

(H)3. When personal protective equipment is removed it shall be
placed in an appropriately designated area or container for storage, washing,
decontamination or disposal.

(IG) Gloves. Gloves shall be worn when it can be reasonably
anticipated that the employee may have hand contact with blood, other potentially
infectious materialsOPIM, mucous membranes, and non-intact skin; when
performing vascular access procedures except as specified in subsection (d)(34)(IG)4.;
and when handling or touching contaminated items or surfaces. These requirements are in
addition to the provisions of Section 3384.

1. Disposable (single use) gloves such as surgical or examination gloves, shall be
replaced as soon as practical when contaminated or as soon as feasible if they are torn,
punctured, or when their ability to function as a barrier is compromised.

2. Disposable (single use) gloves shall not be washed or decontaminated for re-use.

3. Utility gloves may be decontaminated for re-use if the integrity of the glove is not
compromised. However, they must be discarded if they are cracked, peeling, torn,
punctured, or exhibit other signs of deterioration or when their ability to function as a
barrier is compromised.

4. If an employer in a volunteer blood donation center judges that routine gloving for
all phlebotomies is not necessary then the employer shall:

a. Periodically reevaluate this policy;

b. Make gloves available to all employees who wish to use them for phlebotomy;

c. Not discourage the use of gloves for phlebotomy; and

d. Require that gloves be used for phlebotomy in the following circumstances:

i. When the employee has cuts, scratches, or other breaks in his or her skin;

ii. When the employee judges that hand contamination with blood may occur, for example,
when performing phlebotomy on an uncooperative source individual; and

iii. When the employee is receiving training in phlebotomy.

(JH) Masks, Eye Protection, and Face Shields,
and Respirators.

1. Masks in combination with eye protection devices, such as goggles or glasses
with solid side shields, or chin-length face shields, shall be worn whenever splashes,
spray, spatter, or droplets of blood or other potentially infectious materialsOPIM may be generated and eye, nose, or mouth contamination can be reasonably
anticipated. These requirements are in addition to the provisions of Section 3382.

2. Where respiratory protection is used, the provisions of Sections 5144 and
5147applyare required as applicable.

NOTE: Surgical masks are not respirators.

(KI) Gowns, Aprons, and Other Protective Body Clothing.

1. Appropriate protective clothing such as, but not limited to, gowns, aprons,
lab coats, clinic jackets, or similar outer garments shall be worn in occupational
exposure situations. The type and characteristics will depend upon the task and degree of
exposure anticipated. These requirements are in addition to the provisions of Section
3383.

(L)2. Surgical caps or hoods and/or shoe covers or boots shall
be worn in instances when gross contamination can reasonably be anticipated (e.g.,
autopsies, orthopaedic surgery). These requirements are in addition to the provisions of
Section 3383.

(4) Housekeeping.

(A) General. Employers shall ensure that the worksite is maintained in a clean
and sanitary condition. The employer shall determine and implement an appropriate written
schedule for cleaning and method of decontamination based upon the location within the
facility, type of surface to be cleaned, type of soil present, and tasks or procedures
being performed in the area.

(B) All equipment and environmental and working surfaces shall be cleaned and
decontaminated after contact with blood or other potentially infectious materials.

1. Contaminated work surfaces shall be decontaminated with an appropriate
disinfectant after completion of procedures; immediately or as soon as feasible when
surfaces are overtly contaminated or after any spill of blood or other potentially
infectious materials; and at the end of the work shift if the surface may have become
contaminated since the last cleaning.

2. Protective coverings, such as plastic wrap, aluminum foil, or imperviously-backed
absorbent paper used to cover equipment and environmental surfaces, shall be removed and
replaced as soon as feasible when they become overtly contaminated or at the end of the
workshift if they may have become contaminated during the shift.

3. All bins, pails, cans, and similar receptacles intended for reuse which have a
reasonable likelihood for becoming contaminated with blood or other potentially infectious
materials shall be inspected and decontaminated on a regularly scheduled basis and cleaned
and decontaminated immediately or as soon as feasible upon visible contamination.

4. Broken glassware which may be contaminated shall not be picked up directly with the
hands. It shall be cleaned up using mechanical means, such as a brush and dust pan, tongs,
or forceps.

5. Reusable sharps that are contaminated with blood or other potentially infectious
materials shall not be stored or processed in a manner that requires employees to reach by
hand into the containers where these sharps have been placed.

(C) Regulated Waste.

1. Contaminated Sharps Discarding and Containment.

a. Contaminated sharps shall be discarded immediately or as soon as feasible in
containers that are:

i. Closable;

ii. Puncture resistant;

iii. Leakproof on sides and bottom; and

iv. Labeled in accordance with subsection (g)(1)(A) of this section.

b. During use, containers for contaminated sharps shall be:

i. Easily accessible to personnel and located as close as is feasible to the
immediate area where sharps are used or can be reasonably anticipated to be found (e.g.,
laundries);

ii. Maintained upright throughout use, where feasible; and

iii. Replaced routinely and not be allowed to overfill.

c. When moving containers of contaminated sharps from the area of use, the
containers shall be:

i. Closed immediately prior to removal or replacement to prevent spillage or
protrusion of contents during handling, storage, transport, or shipping;

ii. Placed in a secondary container if leakage is possible. The second container shall
be:

A. Closable;

B. Constructed to contain all contents and prevent leakage during
handling, storage, transport, or shipping; and

C. Labeled according to subsection (g)(1)(A) of this section.

d. Reusable containers shall not be opened, emptied, or cleaned manually or in
any other manner which would expose employees to the risk of percutaneous injury.

2. Other Regulated Waste Containment.

a. Regulated waste shall be placed in containers which are:

i. Closable;

ii. Constructed to contain all contents and prevent leakage of fluids during handling,
storage, transport or shipping;

iii. Labeled and color-coded in accordance with subsection (g)(1)(A) of this section;
and

iv. Closed prior to removal to prevent spillage or protrusion of contents
during handling, storage, transport, or shipping.

b. If outside contamination of the regulated waste occurs, it shall be placed
in a second container. The second container shall be:

i. Closable;

ii. Constructed to contain all contents and prevent leakage of fluids during handling,
storage, transport or shipping;

iii. Labeled and color-coded in accordance with subsection (g)(1)(A) of this section;
and

iv. Closed prior to removal to prevent spillage or protrusion of contents during
handling, storage, transport, or shipping.

3. Handling, storage, treatment and disposal of all regulated waste shall be in
accordance with Health and Safety Code Chapter 6.1 and other applicable regulations of the
United States, the State, and political subdivisions of the State.

(D) Laundry.

1. Contaminated laundry shall be handled as little as possible with a minimum
of agitation.

a. Contaminated laundry shall be bagged or containerized at the location where
it was used and shall not be sorted or rinsed in the location of use.

b. Contaminated laundry shall be placed and transported in bags or containers labeled
or color-coded in accordance with subsection (g)(1)(A) of this standard. When a facility
utilizes Universal Precautions in the handling of all soiled laundry, alternative labeling
or color-coding is sufficient if it permits all employees to recognize the containers as
requiring compliance with Universal Precautions.

c. Whenever contaminated laundry is wet and presents a reasonable likelihood of
soak-through of or leakage from the bag or container, the laundry shall be placed and
transported in bags or containers which prevent soak-through and/or leakage of fluids to
the exterior.

2. The employer shall ensure that employees who have contact with contaminated
laundry wear protective gloves and other appropriate personal protective equipment.

3. When a facility ships contaminated laundry off-site to a second facility which does
not utilize Universal Precautions in the handling of all laundry, the facility generating
the contaminated
laundry must place such laundry in bags or containers which are labeled or color-coded in
accordance with subsection (g)(1)(A).

(e) HIV,and HBV and HCV Research Laboratories and
Production Facilities.

(1) General. This subsection applies in addition to the other requirements of this
section to research laboratories and production facilities engaged in the culture,
production, concentration, experimentation, and manipulation of HIV,and
HBV and HCV.

EXCEPTION: This subsection does not apply to clinical or diagnostic laboratories
engaged solely in the analysis of blood, tissues, or organs.

(2) Research laboratories and production facilities shall meet the following criteria:

(A) Standard Microbiological Practices. All regulated waste shall either be incinerated
or decontaminated by a method such as autoclaving known to effectively destroy bloodborne
pathogens. Such methods are further specified in Health and Safety Code Chapter
6.1Section 118215.

(B) Special Practices.

1. Laboratory doors shall be kept closed when work involving HIV,or
HBV or HCV is in progress.

2. Contaminated materials that are to be decontaminated at a site away from the work
area shall be placed in a durable, leakproof, labeled or color-coded container that is
closed before being removed from the work area.

3. Access to the work area shall be limited to authorized persons. Written policies and
procedures shall be established whereby only persons who have been advised of the
potential biohazard, who meet any specific entry requirements, and who comply with all
entry and exit procedures shall be allowed to enter the work areas and animal rooms.

4. When other potentially infectious materialsOPIM or infected
animals are present in the work area or containment module, a hazard warning sign
incorporating the universal biohazard symbol shall be posted on all access doors. The
hazard warning sign shall comply with subsection (g)(1)(B) of this standard.

5. All activities involving other potentially infectious materialsOPIM
shall be conducted in biological safety cabinets or other physical-containment devices
within the containment module. No work with these other potentially infectious
materialsOPIM shall be conducted on the open bench.

6. Laboratory coats, gowns, smocks, uniforms, or other appropriate protective clothing
shall be used in the work area and animal rooms. Protective clothing shall not be worn
outside of the work area and shall be decontaminated before being laundered.

7. Special care shall be taken to avoid skin contact with other potentially
infectious materialsOPIM. Gloves shall be worn when handling infected
animals and when making hand contact with other potentially infectious materialsOPIM is unavoidable.

8. Before disposal, all waste from work areas and from animal rooms shall either be
incinerated or decontaminated by a method such as autoclaving known to effectively destroy
bloodborne pathogens.

9. Vacuum lines shall be protected with liquid disinfectant traps and HEPA filters or
filters of equivalent or superior efficiency and which are checked routinely and
maintained or replaced as necessary.

10. Hypodermic needles and syringes shall be used only for parenteral injection and
aspiration of fluids from laboratory animals and diaphragm bottles. Only needle-locking
syringes or disposable syringe-needle units (i.e., the needle is integral to the syringe)
shall be used for the injection or aspiration of other potentially infectious
materialsOPIM. Extreme caution shall be used when handling needles and
syringes. A needle shall not be bent, sheared, replaced in the sheath or guard, or removed
from the syringe following use. The needle and syringe shall be promptly placed in a
puncture-resistant container and autoclaved or decontaminated before reuse or disposal.

11. All spills shall be immediately contained and cleaned up by appropriate
professional staff or others properly trained and equipped to work with potentially
concentrated infectious materials.

12. A spill or accident that results in an exposure incident shall be immediately
reported to the laboratory director or other responsible person.

13. Written biosafety procedures shall be prepared and adopted into the Exposure
Control Plan of subsection (c)(1). Personnel shall be advised of potential hazards, shall
be required to read instructions on practices and procedures, and shall be required to
follow them.

(C) Containment Equipment.

1. Certified biological safety cabinets (Class I, II, or III) or other appropriate
combinations of personal protection or physical containment devices, such as special
protective clothing, respirators, centrifuge safety cups, sealed centrifuge rotors, and
containment caging for animals, shall be used for all activities with other
potentially infectious materialsOPIM that pose a threat of exposure to
droplets, splashes, spills, or aerosols.

2. Biological safety cabinets shall be certified by the employer that they meet
manufacturers' specifications when installed, whenever they are moved and at least
annually.

(3) HIV,and HBV and HCV research laboratories shall
meet the following criteria:

(A) Each laboratory shall contain a facility for hand washing and an eye wash facility
which is readily available within the work area.

(B) An autoclave for decontamination of regulated waste shall be available.

NOTE: AutoclavesTreatment of medical waste should meet the
requirements of Health and Safety Code Section 25090118215.

(4) HIV,and HBV and HCV production facilities shall
meet the following criteria:

(A) The work areas shall be separated from areas that are open to unrestricted traffic
flow within the building. Passage through two sets of doors shall be the basic requirement
for entry into the work area from access corridors or other contiguous areas. Physical
separation of the high-containment work area from access corridors or other areas or
activities may also be provided by a double-doored clothes-change room (showers may be
included), airlock, or other access facility that requires passing through two sets of
doors before entering the work area.

(B) The surfaces of doors, walls, floors and ceilings in the work area shall be water
resistant so that they can be easily cleaned. Penetrations in these surfaces shall be
sealed or capable of being sealed to facilitate decontamination.

(C) Each work area shall contain a sink for washing hands and a readily available eye
wash facility. The sink shall be foot, elbow, or automatically operated and shall be
located near the exit door of the work area.

(D) Access doors to the work area or containment module shall be self-closing.

(E) An autoclave for decontamination of regulated waste shall be available within or as
near as possible to the work area.

NOTE: AutoclavesTreatment of medical waste should meet the
requirements of Health and Safety Code Section 25090118215.

(F) A ducted exhaust-air ventilation system shall be provided. This system shall create
directional airflow that draws air into the work area through the entry area. The exhaust
air shall not be recirculated to any other area of the building, shall be discharged to
the outside, and shall be dispersed away from occupied areas and air intakes. The proper
direction of the airflow shall be verified (i.e., into the work area). The ventilation
system shall conform to the requirements of Article 107.

(5) Training Requirements.

Training requirements for employees in HIV,and HBV and HCV
research laboratories and HIV,and HBV and HCV production
facilities are specified in subsection (g)(2) and they shall receive in addition the
following initial training:

(A) The employer shall assure that employees demonstrate proficiency in standard
microbiological practices and techniques and in the practices and operations specific to
the facility before being allowed to work with HIV,or HBV or
HCV.

(B) The employer shall assure that employees have prior experience in the handling of
human pathogens or tissue cultures before working with HIV,or HBV
or HCV.

(C) The employer shall provide a training program to employees who have no prior
experience in handling human pathogens. Initial work activities shall not include the
handling of infectious agents. A progression of work activities shall be assigned as
techniques are learned and proficiency is developed. The employer shall assure that
employees participate in work activities involving infectious agents only after
proficiency has been demonstrated.

(A) The employer shall make available the hepatitis B vaccine and vaccination series to
all employees who have occupational exposure, and post-exposure evaluation and follow-up
for bloodborne pathogens exposure to all employees who have had an exposure incident. When
an employer is also acting as the evaluating health care professional, the employer shall
advise an employee following an exposure incident that the employee may refuse to consent
to post-exposure evaluation and follow-up from the employer-healthcare professional. When
consent is refused, the employer shall make immediately available to exposed employees a
confidential medical evaluation and follow-up from a healthcare professional other than
the exposed employees employer.

EXCEPTION: Designated first aid providers who have occupational exposure are not
required to be offered pre-exposure hepatitis B vaccine if the following conditions exist:

1. The primary job assignment of such designated first aid providers is not the
rendering of first aid.

a. Any first aid rendered by such persons is rendered only as a collateral duty
responding solely to injuries resulting from workplace incidents, generally at the
location where the incident occurred.

b. This exception does not apply to designated first aid providers who render
assistance on a regular basis, for example, at a first aid station, clinic, dispensary, or
other location where injured employees routinely go for such
assistance, and emergency or public safety personnel who are expected to render first aid
in the course of their work.

2. The employer's Exposure Control Plan, subsection (c)(1), shall specifically address
the provision of hepatitis B vaccine to all unvaccinated first aid providers who have
rendered assistance in any situation involving the presence of blood or other
potentially infectious materialOPIM (regardless of whether an actual
exposure incident, as defined by subsection (b), occurred) and the provision of
appropriate post-exposure evaluation, prophylaxis and follow-up for those employees who
experience an exposure incident as defined in subsection (b), including:

a. Provisions for a reporting procedure that ensures that all first aid incidents
involving the presence of blood or other potentially infectious materialOPIM
shall be reported to the employer before the end of the work shift during which the first
aid incident occurred.

i. The report must include the names of all first aid providers who rendered
assistance, regardless of whether personal protective equipment was used and must describe
the first aid incident, including time and date.

A. The description must include a determination of whether or not, in addition to the
presence of blood or other potentially infectious materialOPIM,
an exposure incident, as defined in subsection (b), occurred.

B. This determination is necessary in order to ensure that the proper post-exposure
evaluation, prophylaxis and follow-up procedures required by subsection (f)(3) are made
available immediately if there has been an exposure incident, as defined in subsection
(b).

ii. The report shall be recorded on a list of such first aid incidents. It shall be
readily available to all employees and shall be provided to the Chief upon request.

b. Provision for the bloodborne pathogens training program, required by subsection
(g)(2), for designated first aiders to include the specifics of the reporting requirements
of subsection (f)(3) and of this exception.

c. Provision for the full hepatitis B vaccination series to be made available as soon
as possible, but in no event later than 24 hours, to all unvaccinated first aid providers
who have rendered assistance in any situation involving the presence of blood or other
potentially infectious materialOPIM regardless of whether or not a
specific exposure incident, as defined by subsection (b), has occurred.

3. The employer must implement a procedure to ensure that all of the provisions of
subsection 2. of this exception are complied with if pre-exposure hepatitis B vaccine is
not to be offered to employees meeting the conditions of subsection 1. of this exception.

(B) The employer shall ensure that all medical evaluations and procedures,
including the hepatitis B vaccine and vaccination series and post-exposure evaluation and
follow-up, including prophylaxis, are:

1. Made available at no cost to the employee;

2. Made available to the employee at a reasonable time and place;

3. Performed by or under the supervision of a licensed physician or by or under the
supervision of another licensed healthcare professional; and

4. Provided according to recommendations of the U.S. Public Health Service current at
the time these evaluations and procedures take place, except as specified by this
subsection (f).

(C) The employer shall ensure that all laboratory tests are conducted by an accredited
laboratory at no cost to the employee.

(2) Hepatitis B Vaccination.

(A) Hepatitis B vaccination shall be made available after the employee has received the
training required in subsection (g)(2)(G)9. and within 10 working days of initial
assignment to all employees who have occupational exposure unless the employee has
previously received the complete hepatitis B vaccination series, antibody testing has
revealed that the employee is immune, or the vaccine is contraindicated for medical
reasons.

(B) The employer shall not make participation in a prescreening program a prerequisite
for receiving hepatitis B vaccination.

(C) If the employee initially declines hepatitis B vaccination but at a later date
while still covered under the standard decides to accept the vaccination, the employer
shall make available hepatitis B vaccination at that time.

(D) The employer shall assure that employees who decline to accept hepatitis B
vaccination offered by the employer sign the statement in Appendix A.

(E) If a routine booster dose(s) of hepatitis B vaccine is recommended by the U.S.
Public Health Service at a future date, such booster dose(s) shall be made available in
accordance with section (f)(1)(B).

(3) Post-exposure Evaluation and Follow-up.

Following a report of an exposure incident, the employer shall make immediately
available to the exposed employee a confidential medical evaluation and follow-up,
including at least the following elements:

(A) The employer shallDdocumentation of
the route(s) of exposure, and the circumstances under which the exposure incident
occurred;

(B) The employer shallIidentifyication
and documentation of the source individual, unless the employer can
establish that identification is infeasible or prohibited by state or local law;

1. The source individual's blood shall be tested as soon as feasible and after consent
is obtained in order to determine HBV, HCV and HIV infectivity. If consent is not
obtained, the employer shall establish that legally required consent cannot be obtained.
When the source individual's consent is not required by law, the source individual's
blood, if available, shall be tested and the results documented.

2. When the source individual is already known to be infected with HBV, HCV or
HIV, testing for the source individual's known HBV, HCV or HIV status need not be
repeated.

3. Results of the source individual's testing shall be made available to the exposed
employee, and the employee shall be informed of applicable laws and regulations concerning
disclosure of the identity and infectious status of the source individual.

(C) The employer shall provide forCcollection and
testing of the employee's blood for HBV, HCV and HIV serological status;

1. The exposed employee's blood shall be collected as soon as feasible and tested after
consent is obtained.

2. If the employee consents to baseline blood collection, but does not give consent at
that time for HIV serologic testing, the sample shall be preserved for at least 90 days.
If, within 90 days of the exposure incident, the employee elects to have the baseline
sample tested, such testing shall be done as soon as feasible.

3. Additional collection and testing shall be made available as recommended by the U.S.
Public Health Service.

(D) The employer shall provide forPpost-exposure
prophylaxis, when medically indicated, as recommended by the U.S. Public Health Service;

(A) The employer shall ensure that the healthcare professional responsible for the
employee's hepatitis B vaccination is provided a copy of this regulation.

(B) The employer shall ensure that the healthcare professional evaluating an employee
after an exposure incident is provided the following information:

1. A copy of this regulation;

2. A description of the exposed employee's duties as they relate to the exposure
incident;

3. Documentation of the route(s) of exposure and circumstances under which exposure
occurred, as required by subsection (f)(3)(A);

4. Results of the source individual's blood testing, if available; and

5. All medical records relevant to the appropriate treatment of the employee including
vaccination status which are the employer's responsibility to maintain, as required by
subsection (h)(1)(B)2.

(5) Healthcare Professional's Written Opinion.

The employer shall obtain and provide the employee with a copy of the evaluating
healthcare professional's written opinion within 15 days of the completion of the
evaluation.

(A) The healthcare professional's written opinion for hepatitis B vaccination shall be
limited to whether hepatitis B vaccination is indicated for an employee, and if the
employee has received such vaccination.

(B) The healthcare professional's written opinion for post-exposure evaluation and
follow-up shall be limited to the following information:

1. That the employee has been informed of the results of the evaluation; and

2. That the employee has been told about any medical conditions resulting from exposure
to blood or other potentially infectious materialsOPIM which
require further evaluation or treatment.

(C) All other findings or diagnoses shall remain confidential and shall not be included
in the written report.

(6) Medical Recordkeeping. Medical records required by this standard shall be
maintained in accordance with subsection (h)(1) of this section.

(g) Communication of Hazards to Employees.

(1) Labels and Signs.

(A) Labels.

1. Warning labels shall be affixed to containers of regulated waste, refrigerators and
freezers containing blood or other potentially infectious materialOPIM;
and other containers used to store, transport or ship blood or other potentially
infectious materialsOPIM, except as provided in subsection (g)(1)(A)5.,
6. and 7.

NOTE: Other labeling provisions, such as Health and Safety Code Sections 25080-25082118275 through 118320 may be applicable.

2. Labels required by this section shall include either the following legend as
required by Section 3341:

BIOHAZARD

or, in the case of regulated waste, the legend:

BIOHAZARDOUS WASTE or

SHARPS WASTE

as described in Health and Safety Code Sections 25080-25082118275
through 118320.

3. These labels shall be fluorescent orange or orange-red or predominantly so, with
lettering and symbols in a contrasting color.

4. Labels required by subsection (g)(1)(A) shall either be an integral part of the
container or shall be affixed as close as feasible to the container by string, wire,
adhesive, or other method that prevents their loss or unintentional removal.

5. Red bags or red containers may be substituted for labels except for sharp containers
or regulated waste red bags. Bags used to contain regulated waste shall be color-coded red
and shall be labeled in accordance with subsection (g)(1)(A)2. Labels on red bags or red
containers do not need to be color-coded in accordance with subsection (g)(1)(A)3.

6. Containers of blood, blood components, or blood products that are labeled as to
their contents and have been released for transfusion or other clinical use are exempted
from the labeling requirements of subsection (g).

7. Individual containers of blood or other potentially infectious materialsOPIM that are placed in a labeled container during storage, transport, shipment or
disposal are exempted from the labeling requirement.

8. Labels required for contaminated equipment shall be in accordance with this
subsection and shall also state which portions of the equipment remain contaminated.

9. Regulated waste that has been decontaminated need not be labeled or color-coded.

(B) Signs.

1. The employer shall post signs at the entrance to work areas specified in subsection
(e), HIV,and HBV and HCV Research Laboratory and
Production Facilities, which shall bear the following legend:

BIOHAZARD

(Name of the Infectious Agent)

(Special requirements for
entering the area)

(Name, telephone number of the laboratory director or other
responsible person.)

2. These signs shall be fluorescent orange-red or predominantly so, with lettering and
symbols in a contrasting color, and meet the requirements of Section 3340.

(2) Information and Training.

(A) Employers shall ensure that all employees with occupational exposure participate in
a training program which must be provided at no cost to the employee and during working
hours.

(B) Training shall be provided as follows:

1. At the time of initial assignment to tasks where occupational exposure may take
place; and

2. At least annually thereafter.

(C) For employees who have received training on bloodborne pathogens in the year
preceding the effective date of the standard, only training with respect to the provisions
of the standard which were not included need be provided.

(D) Annual training for all employees shall be provided within one year of their
previous training.

(E) Employers shall provide additional training when changes, such as introduction
of new engineering, administrative or work practice controls, modification of tasks or
procedures or institution of new tasks or procedures, affect the employee's
occupational exposure. The additional training may be limited to addressing the new
exposures created.

(F) Material appropriate in content and vocabulary to educational level, literacy, and
language of employees shall be used.

(G) The training program shall contain at a minimum the following elements:

1. Copy and Explanation of Standard. An accessible copy of the regulatory text
of this standard and an explanation of its contents;

2. Epidemiology and Symptoms. A general explanation of the epidemiology and
symptoms of bloodborne diseases;

3. Modes of Transmission. An explanation of the modes of transmission of
bloodborne pathogens;

4. Employer's Exposure Control Plan. An explanation of the employer's exposure
control plan and the means by which the employee can obtain a copy of the written plan;

5. Risk Identification. An explanation of the appropriate methods for
recognizing tasks and other activities that may involve exposure to blood and other
potentially infectious materialsOPIM;

6. Methods of Compliance. An explanation of the use and limitations of methods
that will prevent or reduce exposure including appropriate engineering controls,
administrative or work practicescontrols and personal
protective equipment;

8. Personal Protective Equipment. An explanation of the basis for selection of
personal protective equipment;

9. Hepatitis B Vaccination. Information on the hepatitis B vaccine, including
information on its efficacy, safety, method of administration, the benefits of being
vaccinated, and that the vaccine and vaccination will be offered free of charge;

10. Emergency. Information on the appropriate actions to take and persons to
contact in an emergency involving blood or other potentially infectious materialsOPIM;

11. Exposure Incident. An explanation of the procedure to follow if an exposure
incident occurs, including the method of reporting the incident,and
the medical follow-up that will be made available and the procedure for recording the
incident on the Sharps Injury Log;

12. Post-Exposure Evaluation and Follow-Up. Information on the post-exposure
evaluation and follow-up that the employer is required to provide for the employee
following an exposure incident;

13. Signs and Labels. An explanation of the signs and labels and/or color coding
required by subsection (g)(1); and

14. Interactive Questions and Answers. An opportunity for interactive questions
and answers with the person conducting the training session.

NOTE: Additional training is required for employees of HIV,and
HBV and HCV Research Laboratories and Production Facilities, as described in
subsection (e)(5).

(H) The person conducting the training shall be knowledgeable in the subject matter
covered by the elements contained in the training program as it relates to the workplace
that the training will address.

(h) Recordkeeping.

(1) Medical Records.

(A) The employer shall establish and maintain an accurate record for each employee with
occupational exposure, in accordance with Section 3204.

(B) This record shall include:

1. The name and social security number of the employee;

2. A copy of the employee's hepatitis B vaccination status including the dates of all
the hepatitis B vaccinations and any medical records relative to the employee's ability to
receive vaccination as required by subsection (f)(2);

3. A copy of all results of examinations, medical testing, and follow-up procedures as
required by subsection (f)(3);

4. The employer's copy of the healthcare professional's written opinion as required by
subsection (f)(5); and

5. A copy of the information provided to the healthcare professional as required by
subsections (f)(4)(B)2., 3. and 4.

2. Not disclosed or reported without the employee's express written consent to any
person within or outside the workplace except as required by this section or as may be
required by law.

(D) The employer shall maintain the records required by subsection (h)(1) for at least
the duration of employment plus 30 years in accordance with Section 3204.

(2) Training Records.

(A) Training records shall include the following information:

1. The dates of the training sessions;

2. The contents or a summary of the training sessions;

3. The names and qualifications of persons conducting the training; and

4. The names and job titles of all persons attending the training sessions.

(B) Training records shall be maintained for 3 years from the date on which the
training occurred.

(3) Sharps Injury Log.

The Sharps Injury Log shall be maintained 5 years from the date the exposure
incident occurred.

(34) Availability.

(A) The employer shall ensure that all records required to be maintained by this
section shall be made available upon request to the Chief and NIOSH for examination and
copying.

(B) Employee training records required by this subsection shall be provided upon
request for examination and copying to employees, to employee representatives, to the
Chief, and to NIOSH.

(C) Employee medical records required by this subsection shall be provided upon request
for examination and copying to the subject employee, to anyone having written consent of
the subject employee, to the Chief, and to NIOSH in accordance with Section 3204.

(D)The Sharps Injury Log required by subsection (c)(2) shall be provided
upon request for examination and copying to employees, to employee representatives, to the
Chief, to the Department of Health Services, and to NIOSH.

(45) Transfer of Records.

(A) The employer shall comply with the requirements involving transfer of records set
forth in Section 3204.

(B) If the employer ceases to do business and there is no successor employer to receive
and retain the records for the prescribed period, the employer shall notify NIOSH, at
least three months prior to their disposal and transmit them to the NIOSH, if required by
the NIOSH to do so, within that three month period.

(i) Dates.

(1) The Exposure Control Plan required by subsection (c)(1) of this section shall be
completed within 60 days of the effective date of this standard.

(2) Subsection (g)(2) Information and Training and (h) Recordkeeping shall take effect
within 90 days of the effective date of this standard.

(3) Subsections (d)(2) Engineering and Work Practice Controls, (d)(3) Personal
Protective Equipment, (d)(4) Housekeeping, (e) HIV and HBV Research Laboratories and
Production Facilities, (f) Hepatitis B Vaccination and Post-Exposure Evaluation and
Follow-up, and (g)(1) Labels and Signs, shall take effect 120 days after the effective
date of this standard.

(j) Appendix.

Appendix A to this section is incorporated as a part of this section and the provision
is mandatory.

APPENDIX A - Hepatitis B Vaccine Declination

(MANDATORY)

The employer shall assure that employees who decline to accept hepatitis B vaccination
offered by the employer sign the following statement as required by subsection (f)(2)(D):

I understand that due to my occupational exposure to blood or other potentially
infectious materialsOPIM I may be at risk of acquiring hepatitis B virus
(HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B
vaccine, at no charge to myself. However, I decline hepatitis B vaccination at this time.
I understand that by declining this vaccine, I continue to be at risk of acquiring
hepatitis B, a serious disease. If in the future I continue to have occupational exposure
to blood or other potentially infectious materialsOPIM and I want
to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no
charge to me.